QUT Digital Repository: http://eprints.qut.edu.au/
This is the submitted version of this journal article. To be published as: Courtney, Mary D. and Edwards, Helen E. and Chang, Anne M. and Parker, Anthony W. and Finlayson, Kathleen J. and Bradbury, Carolyn and Nielsen, Zoe (2010) Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission : a randomised controlled trial. Journal of Evaluation in Clinical Practice. (In Press)
© Copyright 2010 Please consult the authors.
Title: Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission: A randomised controlled trial Authors Prof. Mary D. Courtney, PhD Assistant Dean (Research), Faculty of Health Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia
Prof. Helen E. Edwards, PhD Head, School of Nursing and Midwifery Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia
Prof. Anne M. Chang, PhD Professor of Nursing Research (Acute Care) Institute of Health and Biomedical Innovation Queensland University of Technology & Mater Health Services, Brisbane, Australia
Prof. Anthony W. Parker, PhD Professor, School of Human Movements Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia
Ms Kathleen Finlayson, MNsg Institute of Health and Biomedical Innovation
1
Queensland University of Technology, Brisbane, Australia
Ms Carolyn Bradbury, BPhty Physiotherapist, Mater Adult Hospital South Brisbane, Queensland, Australia *
Dr Zoë Nielsen, PhD Senior Research Assistant Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia
Corresponding Author Prof. Mary D. Courtney Faculty of Health, Queensland University of Technology Victoria Park Rd, Kelvin Grove, 4059 Queensland, Australia Ph:
61 7 3138 3887
Fax:
61 7 3138 3814
Email:
[email protected]
Running Title: Improved functional ability in older adults
Key words: older adults, functional ability, exercise, telephone follow-up
*Now employed at Sub-Acute and Residential Care Services Program, Metro North, Brisbane, Australia
2
Abstract Objective: During hospitalisation older people often experience functional decline which impacts on their future independence. The objective of this study was to evaluate a multifaceted transitional care intervention including home-based exercise strategies for atrisk older people on functional status, independence in activities of daily living, and walking ability. Methods: A randomised controlled trial was undertaken in a metropolitan hospital in Australia with 128 patients (64 intervention, 64 control) aged over 65 years with an acute medical admission and at least one risk factor for hospital readmission. The intervention group received an individually tailored program for exercise and follow-up care which was commenced in hospital and included regular visits in hospital by a physiotherapist and a Registered Nurse, a home visit following discharge, and regular telephone follow-up for 24 weeks following discharge. The program was designed to improve health promoting behaviours, strength, stability, endurance and mobility. Data were collected at baseline, then 4, 12 and 24 weeks following discharge using the Index of Activities of Daily Living (ADL), Instrumental Index of Activities of Daily Living (IADL), and the Walking Impairment Questionnaire (Modified). Results: Significant improvements were found in the intervention group in IADL scores (p
